Ballymena Online Referral Form

Would you prefer this patient to be seen by a particular clinician?yesno

If Yes which clinician?:

RA SEDATION:yesno

IV SEDATION:yesno

(Patients having I.V. sedation should fast for 4 hours prior to appointment and be accompanied by a responsible adult, who can take them home and look after them for approx. 6 hours following treatment.)

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